Various Arteries Supplying the Uterus

Description

Along the lateral pelvic wall, the uterine artery courses medially within the base of the broad ligament toward the cervix and lower uterine segment, then ascends in a tortuous pattern along the uterine margin to the fundus. Arcuate arteries run circumferentially within the myometrium, giving off radial arteries that travel from the outer myometrium toward the endometrium, where they continue as straight and spiral arterioles supplying the basal and functional layers. Near the uterine cornu, anastomoses with the ovarian artery and tubal branches typically appear superiorly, while vaginal branches contribute inferiorly around the cervix and upper vagina. Small-caliber arterioles interdigitate between smooth muscle bundles. That ascending uterine arterial course matters in the operating room, because it crosses superior to the ureter near the cervix (the classic water under the bridge relationship), a frequent site of ureteric injury or ligation risk during hysterectomy and uterine artery ligation. The myometrial and endometrial branching pattern is also the substrate for uterine artery embolization in symptomatic leiomyomas, where targeted occlusion reduces fibroid perfusion while relying on collateral flow from ovarian and vaginal contributions. Spiral arteriole physiology explains cyclical endometrial shedding and abnormal uterine bleeding when remodeling fails. Use this artwork in pelvic anatomy teaching for obstetrics and gynecology rotations, in reproductive physiology modules covering endometrial vascular remodeling, and in surgical atlases illustrating hysterectomy, myomectomy, and uterine artery embolization planning. It also suits patient-facing materials that need a clear map of uterine blood supply without sacrificing anatomical rigor. Anatomical accuracy verified by SciePro's Medical Advisory Board.